Neck Disability Index Questionnaire Research Articles

Prevalence of Neck Pain and Associated Disabilities among Students who Use Computers

Background: Neck pain is increasingly prevalent among computer users, leading to significant health concerns and impacting daily activities. Understanding the prevalence and associated disabilities of neck pain in this population is crucial for developing effective preventive measures and interventions. Objective: To investigate the prevalence of neck pain and associated disabilities among university students who use computers, and to identify the factors contributing to these conditions. Methods: This cross-sectional study was conducted over six months at Akhtar Saeed Medical and Dental College, Lahore. A sample of 144 students from DPT, MBBS, BDS, and Pharm-D programs, aged 20-28 years, was selected. Participants included both males and females who used computers for more than two hours daily and had no history of cervical trauma or underlying medical conditions. Data were collected using the Neck Disability Index (NDI) questionnaire and the Numeric Pain Rating Scale (NPRS). Ethical approval was obtained from the Institutional Review Board, and informed consent was secured from all participants. Data analysis was performed using SPSS version 25, with descriptive statistics summarizing demographic information and inferential statistics examining associations between neck pain and risk factors. Results: The study found that 29.2% of participants reported no pain, 20.8% had very mild pain, 45.8% had moderate pain, and 4.2% experienced severe pain. Weak correlations were observed between neck pain and disabilities, with 33.33% of participants able to care for themselves without pain, 62.50% able to care for themselves with extra pain, and 4.17% finding personal care difficult and slow. Regarding headaches, 16.67% reported no headaches, 20.83% had slight headaches infrequently, and 62.50% experienced moderate headaches frequently. Conclusion: The study concluded that a significant number of university students suffer from neck pain due to prolonged computer use, with most experiencing mild to moderate pain. Preventive measures, including ergonomic interventions and educational initiatives on proper posture and taking breaks, are essential to reduce the incidence of neck pain and improve the quality of life for computer users.

Temporomandibular joint and cervical spine disability assessment in people with hypermobility joint syndrome.

Temporomandibular disorders (TMDs) and cervical spine problems are a growing public health issue, as they increase the risk of disability in people with hypermobility joint syndrome (HJS). The present study aimed to assess the prevalence of TMD symptoms, and cervical spine and TMJ disability in HJS patients. A survey was conducted among physical therapy students (mean age: 21 years). The study comprised 2 stages. The 1st one was HJS assessment (the Beighton scale and the Brighton criteria). Based on the assessment, 56 HJS subjects were enrolled for the study. The control group (CG) consisted of 60 HJS-free subjects, according to the aforementioned criteria. The 2nd stage of the study involved conducting a self-administered questionnaire on the prevalence of TMD symptoms. Both the TMD disability questionnaire (TMD-Q) and the neck disability index (NDI) scores were recorded. Pain intensity was assessed using the numeric rating scale (NRS). The HJS group showed higher NRS scores (p < 0.001). Headache, neck and shoulder girdle pain, and temporomandibular joint (TMJ) pain were found to be more severe in almost each patient from the HJS group as compared to CG. Those individuals had a greater degree of disability on the TMD-Q and the NDI scales (p < 0.001). The HJS group showed significant positive correlations between the TMD-Q and NDI scores (p = 0.0035), and between the TMD-Q and TMJ symptom questionnaire scores (p = 0.0047). A significant positive correlation between the NDI and TMJ symptom questionnaire scores was found both in the HJS group (p < 0.001) and CG (p < 0.001). The HJS bearers tended to obtain higher TMJ and cervical spine disability scores, at the same time reporting increased headache, neck and shoulder girdle pain, and TMJ pain intensity. Therefore TMJs should be carefully examined for possible signs of dysfunction in HJS subjects prior to dental or prosthetic treatment. According to our data, TMJ and cervical spine disability assessment should be included as a routine practice in the case of HJS patients, who should remain under the long-term care of a multidisciplinary team of doctors and therapists.

The quality of life after Anterior Cervical Discectomy and Fusion

Cervical discopathy is commonly associated with pain in the cervical spine which may affect patients’ quality of life. If conservative treatment fails to relieve the pain for at least 6 months and/or if neurological deficit progresses, the surgical treatment is taken under consideration. The aim of this study was to evaluate health-related quality of life (HRQOL) and disability of patients after single- and multi-level anterior cervical discectomy and fusion (ACDF) with standalone polyetheretherketone (PEEK) cages. The study evaluated how ACDF influenced particular aspects of patients’ quality of life in the context of radiological outcome. The study included 30 consecutive patients with single- or multi-level cervical disc herniation. Patients underwent clinical and radiological evaluation before and one year after the ACDF procedure. For each patient, we assessed the severity of cervical pain with a numerical rating scale (NRS) and filled the neck disability index questionnaire (NDI). The health-related quality of life was assessed with the Polish version of 36-Item Short Form Survey (SF-36). A significant decrease in all NDI aspects indicates a significant improvement after surgery. The quality of life in all aspects assessed with SF-36 scale was also improved. A moderate decrease in cervical spine mobility coexisted with a good outcome of the neurosurgical procedure. In the opinion of patients, the most important aspect after the cervical spine surgery is the reduction of pain severity. ACDF surgery is an effective method to reduce the severity of pain in patients with degenerative disc disease. ACDF improves the quality of patient’s life. According to the study results the physical role improved most significantly; the least improvement was noted in role-emotional aspect. Up to 83% of patients achieved a reduction of the NDI index by 5 or more points after surgical treatment which proves the high effectiveness of the surgical treatment. No statistically significant difference was noted between patients with single and multi – level discopathy. Up to 97% of patients who underwent ACDF reported a significant decrease in pain severity measured with NRS.

Effects of scapular treatment on chronic neck pain: a systematic review and meta-analysis of randomized controlled trials

BackgroundChronic neck pain (CNP) is a common public health problem that affects daily living activities and quality of life. There is biomechanical interdependence between the neck and scapula. Studies have shown that shoulder blade function might be related to chronic neck pain. We therefore evaluated the effects of scapular targeted therapy on neck pain and function in patients with CNP.MethodsDatabases, including MEDLINE (via PubMed), EMBASE (via Ovid), Ovid, Web of Science, and Scopus, were systematically searched for randomized controlled trials published in English investigating treatment of the scapula for CNP before July 16, 2023.ResultsA total of 313 participants were included from 8 RCTs. Compared with those in the control group, the intervention in the scapular treatment group exhibited greater improvement in pain intensity (standardized mean difference (SMD) = 2.55; 95% CI = 0.97 to 4.13; P = 0.002), with moderate evidence. Subgroup analysis for pain intensity revealed a significant difference between the sexes, with only the female population (SMD = 6.23, 95% CI = 4.80 to 7.65) showing better outcomes than those with both sexes (SMD = 1.07, 95% CI = 0.57 to 1.56) (p < 0.00001). However, moderate evidence demonstrated no improvement in neck disability after scapular treatment (SMD of 0.24[-0.14, 0.62] of Neck Disability Index or Northwick Park Neck Pain Questionnaire). No effect of scapular treatment was shown on the pressure pain threshold (PPT). The cervical range of motion (CROM) and electromyographic activity of neck muscles could not be conclusively evaluated due to limited support in the articles, and further study was needed. However, the patient’s head forward posture appeared to be corrected after scapular treatment.ConclusionScapular therapy was beneficial for relieving pain intensity in patients with CNP, especially in women. Head forward posture might also be corrected with scapular therapy. However, scapular therapy may have no effect on the PPT or neck disability. However, whether scapular therapy could improve CROM and cervical muscle activation in patients with CNPs had not been determined and needed further study.

Prevalence and Association of Neck Disability Index (NDI) with Forward Head Posture (FHP) among Pharm D Students

Background: Forward Head Posture (FHP) is a prevalent condition characterized by the anterior positioning of the cervical spine, leading to increased cervical lordosis. This posture has been associated with various musculoskeletal disorders, particularly among students who spend prolonged periods in sedentary activities, such as reading or using computers and smartphones. The relationship between FHP, the Neck Disability Index (NDI), and the Craniovertebral (CV) angle is crucial for understanding the impact of this postural deviation on neck disability. Objective: The study aimed to determine the prevalence of FHP among Pharm-D students at the Margalla Institute of Health Sciences, Rawalpindi, and to assess the association between the NDI and CV angle in this population. Methods: A descriptive cross-sectional study design was employed, involving 169 Pharm-D students selected through convenient non-probability sampling. The ON Protractor application was used for photogrammetric measurements of the CV angle, while the NDI questionnaire assessed neck disability. Data analysis was conducted using SPSS version 25, with correlation coefficients calculated to explore the associations between FHP, NDI, and CV angle. Results: The prevalence of FHP among the participants was found to be 84%. The majority of students (63.3%) exhibited light disability according to the NDI. The mean CV angle was 41.49 degrees in standing and 41.5 degrees in sitting positions. No significant correlation was observed between the CV angle and NDI (r=0.357 in sitting and r=0.162 in standing positions), indicating that the degree of FHP was not directly related to the level of neck disability. Conclusion: FHP is highly prevalent among Pharm-D students, with a significant proportion experiencing light neck disability. However, the study found no significant correlation between the severity of FHP (as measured by the CV angle) and neck disability. These findings underscore the need for targeted interventions to address FHP and prevent neck disabilities in this population.

Assessment of physical activity levels and back pain among poles and Portuguese in the further year of the COVID-19 pandemic - a pilot study

BackgroundThe vast majority of people have experienced the problem of back pain at least once in their lives for a variety of reasons. It is well known that regular physical activity at a moderate level has a number of health benefits regardless of age or gender with positive effects on the musculoskeletal, cardiovascular, respiratory or nervous systems improving fitness levels. During the pandemic, Poland experienced one of the longest periods of school lockdown in Europe. In Portugal, this period was considerably shorter. The aim of this study was to determine the level of physical activity and back pain as well as relationship between physical activity and back pain in a group of Polish and Portuguese students in the following year the COVID-19 pandemic.MethodsThe study was conducted via the Internet among students from Poland and Portugal (398 respondents − 229 from Poland and 169 from Portugal) in October 2022. In the pilot study, the International Physical Activity Questionnaire and The Oswestry Disability Index and Neck Disability Index questionnaires were used to assess the level of back pain.ResultsThere are no statistically significant differences in the level of physical activity and pain complaints of respondents from the two countries. At least half of the students do not report any pain complaints (median in some groups being 0). In the Portuguese men, there is a correlation between the level of physical activity and the Neck Disability Index score (p = 0.0304).ConclusionsThe following year, after the pandemic COVID-19 was declared, the prevalence of back pain among students in Poland and Portugal is still significant.

Randomised controlled trial assessing the effects of 6-week telerehabilitation exercise programme on chronic non-specific neck pain: a study protocol

Chronic non-specific neck pain is one of the most common musculoskeletal conditions affecting the work and lifestyle of those suffering from it. Physiotherapy interventions, such as strength training and stretching,...

Cervical spondylotic myelopathy and driving abilities: defining the prevalence and long-term postoperative outcomes using the Quality Outcomes Database.

Cervical spondylotic myelopathy (CSM) can cause significant difficulty with driving and a subsequent reduction in an individual's quality of life due to neurological deterioration. The positive impact of surgery on postoperative patient-reported driving capabilities has been seldom explored. The CSM module of the Quality Outcomes Database was utilized. Patient-reported driving ability was assessed via the driving section of the Neck Disability Index (NDI) questionnaire. This is an ordinal scale in which 0 represents the absence of symptoms while driving and 5 represents a complete inability to drive due to symptoms. Patients were considered to have an impairment in their driving ability if they reported an NDI driving score of 3 or higher (signifying impairment in driving duration due to symptoms). Multivariable logistic regression models were fitted to evaluate mediators of baseline impairment and improvement at 24 months after surgery, which was defined as an NDI driving score < 3. A total of 1128 patients who underwent surgical intervention for CSM were included, of whom 354 (31.4%) had baseline driving impairment due to CSM. Moderate (OR 2.3) and severe (OR 6.3) neck pain, severe arm pain (OR 1.6), mild-moderate (OR 2.1) and severe (OR 2.5) impairment in hand/arm dexterity, severe impairment in leg use/walking (OR 1.9), and severe impairment of urinary function (OR 1.8) were associated with impaired driving ability at baseline. Of the 291 patients with baseline impairment and available 24-month follow-up data, 209 (71.8%) reported postoperative improvement in their driving ability. This improvement seemed to be mediated particularly through the achievement of the minimal clinically important difference (MCID) in neck pain and improvement in leg function/walking. Patients with improved driving at 24 months noted higher postoperative satisfaction (88.5% vs 62.2%, p < 0.01) and were more likely to achieve a clinically significant improvement in their quality of life (50.7% vs 37.8%, p < 0.01). Nearly one-third of patients with CSM report impaired driving ability at presentation. Seventy-two percent of these patients reported improvements in their driving ability within 24 months of surgery. Surgical management of CSM can significantly improve patients' driving abilities at 24 months and hence patients' quality of life.

Comparison of McKenzie and Isometric Exercises on Neck Functions of Computer Users with Forward Head Posture

Introduction: Prolonged use of computer can lead to poor posture such as forward head posture (FHP). This posture is associated with imbalance and stiffness of the neck muscles, lack of postural awareness and inappropriate ergonomics, resulting in work-related musculoskeletal disorders. These disturbances can affect the performance and productivity of office workers. Postural awareness training, neck exercises, and modalities are interventions in FHP management. Research that compares the effectiveness of cervical McKenzie and isometric exercise on neck functional score in computer users with forward head posture has not been conducted.&#x0D; Methods: This research was a quasi-experimental. The participants, 24 computer users working at Kariadi Hospital, Semarang, were divided into 2 groups by purposive sampling receiving cervical McKenzie exercise (n=12) and cervical isometric exercise (n=12). Each group received different exercise. Neck functional score was assessed by Neck Disability Index (NDI) questionnaire before and after intervention. The mean differences before and after treatment, as well as between groups was compared statistically using paired t-test.&#x0D; Results: The mean NDI score in the McKenzie group after treatment showed an improvement of 7.84 ± 3.54 with p = 0.002. The mean NDI score in the isometric group after treatment also showed an improvement of 3.93 ± 3.75 with p = 0.004. The difference in NDI score improvement in the cervical McKenzie group was greater than the one in isometric group and statistically significant with p = 0.017.&#x0D; Conclusion: Cervical McKenzie exercise was proved to be more effective in improving neck functional scores in patients with FHP compared to cervical isometric exercise.

Efficacy of cervical mobilization with post-isometric relaxation in managing mechanical neck pain, ROM, and functional limitations associated with myofascial trigger points

Background: Sedentary lifestyle, age-related degenerative changes or traumatic injuries leads to cervical spine structural mal-alignment, which results in neck pain and other symptoms. Various therapeutic exercises and manual techniques have been proven to be beneficial in terms of managing these symptoms. This study aimed to determine the combined effects of cervical mobilization and post-isometric relaxation (PIR) technique on managing neck pain, cervical side flexion range of motion, and functional limitation in participants with mechanical neck pain linked with myofascial trigger points. Methods: This study followed a 2-arm, parallel-group, pretest-posttest randomized comparative design. Thirty participants with mechanical neck pain associated with myofascial trigger points aged 30.87 ± 4.45 years were randomly allocated to Groups 1 and 2. Group 1 received conventional intervention, PIR, and cervical mobilization techniques while Group 2 received conventional intervention and PIR technique only. Neck pain, muscle tenderness, cervical range of motion, and functional limitations were assessed using a visual analog scale, pressure pain threshold (PPT), goniometer, and neck disability index (NDI) questionnaire, respectively at baseline on day 1 and post-intervention on day 7, 14, and 21. Wilcoxon signed-rank test and the Mann–Whitney U test evaluated within-group and between-group analyses, respectively. Statistical significance was established at a 95% confidence interval, indicated by P &lt; .05. Results: Significant differences (95% confidence interval [CI], P &lt; .05) were observed within each group for all the outcomes scores when compared to the baselines across multiple time points. Significant variations were observed between the groups when comparing visual analog scale and NDI scores at weeks 1, 2, and 3 post-interventions. In contrast, insignificant differences (95% CI, P &gt; .05) were observed for side flexion range of motion and PPT compared at weeks 1, 2, and 3 post-interventions except for PPT at week 3 post-intervention (95% CI, P &lt; .05). Additionally, Cohen d test revealed the superiority of group 1 over group 2 in reducing pain and functional limitations and improving cervical side flexion range of motion and PPT. Conclusion: The combination of cervical mobilization and Post-isometric relaxation techniques was discovered to effectively alleviate neck pain and enhance functional abilities when contrasted with the application of post-isometric relaxation alone in patients with mechanical neck pain linked with myofascial trigger points.

Comparison of Treatment Outcome of the Effectiveness of Isometric Exercises as Compared to General Exercises with Cervical Spine Mobilization in The Management of Chronic Non Specific Neck Pain

The purpose of this study was to evaluate the “effectiveness of isometric exercises as compared to general exercises along with cervical spinal mobilization to reduce pain, disability and to increase range of motion in chronic non-specific neck pain”For this randomized controlled experiment total 32 patients (16 in each group) with chronic non-specific neck pain were recruited from physiotherapy Ward Mayo Hospital Lahore, Department of Physiotherapy King Edward Medical University Lahore between October, 2019 and March, 2020. Simple randomization method was used to assign participants into isometric exercise group and general exercise with cervical spine mobilization group. The isometric exercise group performed exercises for neck muscle groups with a rubber band and general exercises with cervical mobilization group performed active range of movement exercises for all neck movements. Patients in both groups received 4 supervised treatment sessions per week for 6 weeks. Visual Analogue Scale (VAS), Neck disability index Questionnaire and goniometer were used to assess pain, disability and neck range of movements at baseline and after 6 weeks.Both interventions showed statistically significant improvements in pain, function and range of movement p = 0.001for isometric exercise group, p = 0.05 for general exercises group and p= &lt;0.001 for range of movement. However, mean improvements in post intervention VAS score and Neck disability index Questionnaire score was better in isometric exercises group as compared to general exercise group. In conclusion, both interventions are effective in the treatment of chronic non- specific neck pain however; isometric exercises are clinically more effective than general exercises with cervical spine mobilization.

The Prevalence of Neck and Back Pain among Paramedics in Poland.

Neck Pain (NP) and low back pain (LBP) are ubiquitous musculoskeletal conditions and some of the major causes of disability worldwide. The aim of the study was to assess the incidence and risk factors of back pain among paramedics and their correlation with the nature of work, anthropometric features and the level of recreational physical activity. A group of 201 individuals (39 females (19.40%); 162 males (80.60%)), licensed to practice as paramedics in Poland completed a questionnaire containing the author's interview as well as the Neck Disability Index (NDI) questionnaire and the Revised Oswestry Disability Index (ODI). Among the examined paramedics, 92% of the subjects reported the presence of back pain in different parts of the spine (36% C; 17% Th; and 85% LBP). The pain intensity, determined by VAS, was on average 4.26 (SD 1.77). The level of disability, assessed by NDI, was 7.67 (SD 5.73) on average, while the ODI was 7.51 (5.90). Work-related spinal strain has a major impact on the intensity and incidence of spinal pain. Spinal pain in paramedics mainly occurs in the lower back.

The “Cristo Re” hospital experience on telerehabilitation for treatment post thyroidectomy neck pain

Abstract Background Thyroidectomies are one of the most frequently performed endocrine surgical procedures and are mostly consequent to thyroid cancers with about 80% of patients develop neck pain and stiffness. For better management in a public health setting, Cristo Re Hospital in Rome has designed specific physiotherapy based on selective stretching and strengthening of neck muscles combined with breathing. Methods The study enrolled 26 patients with a mean age of 51.2 years: 20 were treated with total thyroidectomy and 6 with thyroid lobectomy. Follow-up was performed at 1 day, 1 week and 1 month after surgery. We used for assessment: Visual Analog Scale (VAS), Neck Pain and Disability Scale-I (NPDS-I), Short Form-12 (SF12), Disability of the Arm, Shoulder and Hand (DASH), Neck Disability Index Questionnaire (NDI). The patients performed 10 therapeutic sessions: the first in the hospital on the first post-surgery day, the others in telerehabilitation 3 times a week (40 min. each) for 3 weeks. A nonparametric Friedmann test was analyzed the differences between the scale averages at T0/T1 and T2. Using case-control analysis the effects of treatment duration (&amp;lt;vs&amp;gt;90 min.) were assessed with the U-Mann-Whitney test. Results A statistically significant improvement was shown in the Physical Component Summary- SF12 at 1 week and 1 month after treatment (+3 pts at T1, +13.2 at T2 p &amp;lt; 0.001), while no significant changes in the Mental Component Summary. The averages of NPDS-I, NDI and DASH also decreased at T1 and T2 demonstrating the effectiveness of the protocol (-37.7 median points,-18.3 mp,-34.5 mp,-35 mp, respectively p &amp;lt; 0.001). No significant change in VAS scale at T1 and T2 and in patients treated for more or less than 90 minutes. Conclusions This protocol is useful for reducing neck pain and improving quality of life and can be recommended as a therapy after thyroidectomy with a strong reduction in cost and morbidity, being able to treat patients even in telerehabilitation. Key messages • Therapy after thyroidectomy that, by being able to treat patients even in telerehabilitation, reduces hospitalization rates, costs, and morbidity due to neck pain, with increased quality of life. • New low-cost methodology for neck physiotherapy after thyroidectomy, also performed in telerehabilitation, which improves quality of life and ability of movement while greatly reducing pain.

Use of transforaminal epidural blocks in patients with radiculopathy caused by herniated disc of the cervical spine

Aim of the research. To study the efficacy and safety of treating patients with cervical radicular pain that is resistant to conservative treatment. Material and methods. The results of treatment of 30 patients with herniated discs of the cervical spine and persistent radicular pain syndrome, who had an indication for surgical treatment, were studied. All subjects underwent transforaminal epidural block (TEB), and in case of its low efficiency, the patients were offered surgical treatment. The patients'condition was assessed in dynamics over 2 years, including on the basis of indicators of the visual analog scale (VAS), the Neck Disability Index (NDI) questionnaire, and motor dysfunction in the limb according to the MRC Scale for Muscle Strength (MRC). Results. After 1 month: 21 (70 %) patients noted a significant (at least 50 %), persistent decrease in the intensity of radicular pain during the first month after TEB; a decrease in NDI values was noted in all patients. In 83.3 % (n-10) of the patients, there was a complete recovery of motor function in the limb. Two (6.7 %) patients underwent surgical treatment. After 24 months: All patients maintained a decrease in NDI scores (median 4 [0;6]). In 21 (70 %) patients, a stable positive effect from the conducted TEB remained. Four (13.3 %) patients were operated on, while five (16.7 %) patients refused surgical treatment and continued conservative treatment with a positive effect over time. Thus, all patients showed a significant decrease in the intensity of radicular and local pain in the neck with a median of 0 [0;0]. A complete restoration of muscle strength was found in all patients with moderate paresis of the arm before manipulation (n-12). Only 5 patients (16.7 %) retained periodic moderate (not exceeding 3 points by the VAS) local pain in the neck, and four (13.3 %) patients noted periodic, mild (not exceeding 3 points by the VAS) radicular pain. Conclusion. The use of TEB in the treatment of patients with radiculopathy caused by herniated discs of the cervical spine prevents the need for surgical treatment in 70 % of the patients, while maintaining a high quality of life.

Effectiveness of Modified Scapular Exercise and Stretching Exercise on Pressure Pain and Neck Disability in Architecture Students with Mechanical Neck Pain in Denpasar

This study aimed to prove the difference in the effectiveness of modified scapular exercise compared to stretching exercise in pressure pain and neck disability in architecture students with mechanical neck pain in Denpasar. This research is experimental research with pre and post-test two-group design. The research sample consisted of 16 people who were divided into two groups by simple random sampling. Group 1 with the modified scapular exercise intervention and group 2 with the stretching exercise intervention. Both groups received treatment 3 times a week for 6 weeks. Measurements were made before and after treatment. Pressure pain was measured with a pressure algometer and neck disability were measured with the Indonesian version of the neck disability index questionnaire. Based on the paired sample t-test on modified scapular exercise and stretching exercise, the results obtained were right and left pressure pain with a value of p&lt;0.001 and neck disability with p&lt;0.001, which means that there was a significant difference in the decrease of pressure pain and neck disability before and after the intervention, in each group. For the independent sample t-test, the value of right pressure pain was p&lt;0.05, left pressure pain was p&lt;0.05, and neck disability was p&lt;0.001, which showed significant differences in the decrease of pressure pain and neck disability in the two groups. In conclusion, modified scapular and stretching exercises can decrease pressure pain and neck disability in architecture students with mechanical neck pain in Denpasar. However, based on the analysis of the results of the intervention, modified scapular exercise was more effective in decreasing pressure pain and neck disability in architecture students with mechanical neck pain compared to stretching exercise.

Recommendations for a core outcome measurement set for clinical trials in whiplash associated disorders.

Inconsistent reporting of outcomes in clinical trials of treatments for whiplash associated disorders (WAD) hinders effective data pooling and conclusions about treatment effectiveness. A multidisciplinary International Steering Committee recently recommended 6 core outcome domains: Physical Functioning, Perceived Recovery, Work and Social Functioning, Psychological Functioning, Quality of Life and Pain. This study aimed to reach consensus and recommend a core outcome set (COS) representing each of the 6 domains. Forty-three patient-reported outcome measures (PROMs) were identified for Physical Functioning, 2 for perceived recovery, 37 for psychological functioning, 17 for quality of life, and 2 for pain intensity. They were appraised in 5 systematic reviews following COSMIN methodology. No PROMs of Work and Social Functioning in WAD were identified. No PROMs had undergone evaluation of content validity in patients with WAD, but some had moderate-to-high-quality evidence for sufficient internal structure. Based on these results, the International Steering Committee reached 100% consensus to recommend the following COS: Neck Disability Index or Whiplash Disability Questionnaire (Physical Functioning), the Global Rating of Change Scale (Perceived Recovery), one of the Pictorial Fear of Activity Scale-Cervical, Pain Self-Efficacy Questionnaire, Pain Catastrophizing Scale, Harvard Trauma Questionnaire, or Posttraumatic Diagnostic Scale (Psychological Functioning), EQ-5D-3L or SF-6D (Quality of Life), numeric pain rating scale or visual analogue scale (Pain), and single-item questions pertaining to current work status and percent of usual work (Work and Social Functioning). These recommendations reflect the current status of research of PROMs of the 6 core outcome domains and may be modified as evidence grows.

Self-Management Exercises Intervention on Text Neck Syndrome Among University Students Using Smartphones

BackgroundThe prevalence of neck pain due to the overuse of mobile phones has been reported among university students. AimThis study aims to investigate the impact of self-management corrective exercises on text neck syndrome among university students using smartphones. MethodsThis experimental study was conducted on 60 students in the two experimental and control groups. Demographic information and the Neck Disability Index (NDI) questionnaires were used for data collection. The Severity of Neck Pain (SNP) was determined using the visual analog scale. The head and neck tilt angles, the gaze angle, and the amount of change in the forward head posture were determined using photogrammetry and Kinovea software. The experimental group performed corrective exercises 5 days a week for 8 weeks. The desired variables were re-determined in both groups after the intervention. ResultsThe SNP and NDI in the experimental group after the intervention decreased by 0.61-1.45, and 1.20-5.14, respectively. Significant differences between the measured variables before and after the intervention in the experimental group showed that the head tilt angle (7.17-22.30 degrees), gaze angle (3.21-23.5 degrees), and forward head posture (3.26-5.42 cm) were reduced, and the neck tilt angle (2.00-17.24 degrees) increased and improved after the intervention in various measurement positions. ConclusionsAfter performing the corrective exercises, 36.6% of the SNP and 13.3% of the NDI were reduced in the experimental group. Head and neck angles during using smartphones in a sitting position on a chair without a backrest were the most awkward posture compared with other postures.

Forward head posture and neck disability: what is the effect on lung function?

Aim: Forward head posture (FHP) is a very common pathological neck posture among people who frequently use multimedia devices, and it could be related to some musculoskeletal disorders. However, its role in influencing lung function and its relationship with neck disability are still debated in the literature. Therefore, the aim of the present study was to investigate the influence of FHP on respiratory function, and to explore a possible relationship between FHP and neck discomfort. Methods: A cross-sectional study was conducted on a sample of 83 subjects (35.7 ± 8.4 years aged), enrolled at the Ferrari corporate wellness program “Formula Benessere”. Craniovertebral angle (CVA) was measured with a digital goniometer to assess head posture: FHP was defined with a CVA &lt; 50° in an upright position. Spirometry was conducted according to European Respiratory Society/American Thoracic Society (ERS/ATS) criteria. Finally, subjects enrolled were evaluated through a self-administered neck disability index (NDI) questionnaire. Results: Among the 60 participants with agreement about the CVA measurements, 45 had FHP (11 females and 34 males) with lower CVA values. No significant differences were found in spirometric parameters between subjects with FHP (n = 45) and subjects without FHP (n = 15). Furthermore, the two groups did not differ either in NDI scores (P = 0.148). Conclusions: There is no clear relationship between FHP and respiratory function indices. Moreover, no differences have been found in NDI values between subjects with FHP and subjects without FHP. Respiratory rehabilitation strategies should be focused on other parameters than FHP itself.

Comparative Outcome of Lidocaine Versus Bupivacaine for Cervical Medial Branch Block in Chronic Cervical Facet Arthropathy: A Randomized Double-Blind Study

This study evaluated the effect of prolonged concordant response and functional clinical improvement between lidocaine and bupivacaine for cervical medial branch block (CMBB) in chronic cervical facet syndrome. Sixty-two patients diagnosed with chronic cervical facet syndrome were randomized into either lidocaine or bupivacaine groups. The therapeutic CMBB was performed under ultrasound guidance. Either 2% lidocaine or 0.5% bupivacaine with a volume of 0.5-1 ml per level, according to the patient's pain symptoms. The patients, pain assessor, and pain specialist were blinded. The primary outcome was the duration of pain reduction by at least 50%. The numerical rating scale (NRS) of 0-10 and the Neck Disability Index (NDI) questionnaire were recorded. There was no significant difference in the duration of 50% and 75% pain reduction and NDI between the lidocaine and bupivacaine groups. Lidocaine provided significant pain reduction up to 16 weeks (P<0.05) and significant improvement in neck functional outcomes up to 8 weeks (P<0.01) compared to the baseline. Whist bupivacaine yielded significant pain alleviation for up to 8 weeks for pain upon neck mobilization (P<0.05) and demonstrated notable improvement in neck function up to 4 weeks (P<0.01) compared to the baseline. CMBB using lidocaine or bupivacaine provided clinical benefits in prolonged analgesic effect and improving neck functions for chronic cervical facet syndrome. Lidocaine illustrated better performance and could be considered a local anesthetic of choice regarding the prolonged concordance response.

Ultrasound-guided pulsed radiofrequency of cervical nerve root for cervical radicular pain: a prospective randomized controlled trial

Pulsed radiofrequency (PRF) on cervical dorsal root ganglion (DRG) for pain management in cervical radicular pain is mainly performed via a transforaminal approach under fluoroscopic guidance. Ultrasound-guidance periradicular cervical nerve root intervention raises concern about the neuromodulatory effect. This study aims to evaluate the effectiveness and duration of pain relief between PRF treatment and steroid injection on the cervical nerve roots. To evaluate the efficacy of pulsed radiofrequency for cervical radicular pain. A prospective, double-blinded, randomized controlled clinical trial PATIENT SAMPLE: Patients who underwent ultrasound-guided periradicular cervical nerve root PRF or steroid injection from January 2020 to May 2021 at King Chulalongkorn Memorial Hospital (KCMH), Bangkok, Thailand. The primary outcome was the pain score at 3 months postprocedure. The secondary outcomes were the duration of pain relief of at least 50%, pain scores at other time points after pain intervention, the amount of rescue pain medications, procedural time, and complications. Forty-two patients who presented with chronic cervical radicular pain were prospectively randomized into the PRF and steroid groups. Patients in the PRF group received PRF treatment at 42°C for 4 minutes, followed by the injection of 2% lidocaine 1.5 mL and dexamethasone 10 mg to the targeted cervical nerve root. The steroid group received the same injectate. Patients and pain assessors were blinded. The numerical rating scale (NRS) and the Neck Disability Index (NDI) questionnaires were used for pain intensity and neck functional assessment before and after the procedure. Pain reduction was recorded up to a 9-month follow-up. Data analysis was obtained from 20 and 21 patients receiving PRF and steroid treatment, respectively. At 3-month postprocedure, there were 70% of patients in the PRF group reported 50% pain reduction compared with 23.8% of patients in the steroid group (p<.01). Moreover, patients in the PRF group had significantly less pain (NRS 2.8±2.7) compared with patients in the steroid group (NRS 5.5±2.6) (p=.01). The neck disability index demonstrated significant improvement at 3 and 6 months (p<.01) after PRF treatment compared with steroid injection alone. The duration, in which pain relief was at least 50%, was significantly longer in patients who received PRF treatment (6.0±4.1 months) compared with those in the steroid group (2.3±2.1 months) (p<.01). Ultrasound-guided periradicular cervical nerve root PRF exhibited a neuromodulatory effect and was considered effective for patients with cervical radicular pain. It provided a longer duration of pain relief and improvement of neck function for up to 6 months.